• Journal of Chest Surgery
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• v.52 no.4
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• pp.248-329
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• 2019

Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

• Korean Journal of Ecology and Environment
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• v.52 no.3
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• pp.245-265
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• 2019

Biotope, which represents the characteristic habitats of living organisms, need to be identified as essential for the efficient creation and sustainable management of urban ecosystems. This study was carried out to provide the basic information for ecological urban planning by analyzing types and attributes of the biotop established throughout the whole area of the Pohang city, a representative industrial city in Korea. The biotop established in Pohang city is composed of 12 types including forests (coniferous, deciduous, and mixed forests), agricultural fields (rice paddy and upland field), green facilities, river, reservoir, bare ground, residential area, public facilities, commercial area, industrial area, roads, and schools. As a result of analyzing the properties according to biotop types, industrial, commercial and residential areas, which represent urban areas, was dominated by introduced vegetation. Moreover the introduced vegetation is usually composed of exotic plants or modified forms for landscape architecture and horticulture rather than native plants, which reflects ecological property of both region and site. As the distance from the urban center increases, the agricultural field showed a form of typical farmland, whereas the closer it is, the more form of greenhouse farming. Natural green spaces were divided into riparian vegetation established along the stream and forest vegetation. Forest vegetation is consisted of secondary forests (seven communities) and plantations (three communities). The urban landscape of Pohang city is dominated by the industrial area. Among them, the steel industry, which occurs large amounts of heat pollution and carbon dioxide, occupies a large proportion. On the other hand, green space is very insufficient in quantity and inferior in quality. This study proposed several restoration plans and further, a green network, which ties the existing green spaces and the green space to be restored as a strategy to improve the environmental quality in this area.

• Journal of Korean Society of Forest Science
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• v.100 no.2
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• pp.292-304
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• 2011

The purpose of this study is to draw institutional implications for tree cutting permit system improvement in comparison with Korea and foreign countries (German, Japan). A survey about recognition of cutting system and cutting-invigorating factors for two groups in charge of work for cutting permit (forest-official) and cutting operation (forest owner, tree butcher, forestry association, and forestry corporation) was carried out. The survey provides basic information which is necessary to improve current cutting system. The result of analysis about both German and Japan's cutting system show that clear cutting area to hinder function of forests tends to decrease and flexible final age of maturity considering condition of regional forest not uniform cutting age were applied. As a result of German and Japan's cutting system review flexible cutting system on regional characteristics is used to manage for the purpose of forest regeneration. The survey result about awareness and invigorating factors of cutting system represents that only public official group said final age of pine tree (3.13) and cedar (3.05) was proper and final age of other species of trees should have shortened. In matters of cutover area, current standard is less than 5ha per a felling area and the largest total area limit is 30 ha, only tree butcher, forestry corporation said cutover area must expand. Invigorating factors of current cutting system are reinforcement of cutover area, facility support, enrichment of technical training, increase of equipment support, simplification of administrative procedures, and provision of various benefits. The reinforcement of technical training among them especially represents the statistical significance of the participants' differential recognition.

• The Journal of the Korean Institute of Forest Recreation
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• v.22 no.4
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• pp.11-22
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• 2018

This study analyzes the economic feasibility on the transition of production structure to increase income for a local forest village in Laos PDR. The study area was the Nongboua village in Sangthong district where the primary product is rice from rice paddy. Possible strategies were considered to increase the villagers' revenue, and Noni (Morinda citrifolia) was production in the short-term. We assumed that the project period was for 20 years for the analysis, and a total of 1,100 Noni tree was planted in 1 ha by $3m{\times}3m$ spacing. This study classified basic scenario one, scenario two, scenario three by the survival rate and purchase pirce of Noni. Generally Noni grows well. However, the seedlings' average survival rate (= production volume) was set up conservatively in this study to consider potential risks such as no production experience of Noni and tree disease. The scenario one assumed that the survival rate of Noni seedlings was 50% for 0-1 years, 60% for 0-2 years, and 70% for 3-20 years; the scenario two, 10% less, i.e., 40%, 50%, and 60%; and the scenario three, 10% less, i.e., 40%, 50%, 60% and purchase price 10% less, i.e., $0.29 to $0.26, respectively. Our analysis showed that all 3 scenarios resulted in economically-feasible IRR (internal rate of return) of 24.81%, 19.02%, and 16.30% of with a discounting rate of 10%. The B/C (benefit/cost) ratio for a unit area (1ha) was also analyzed for the three scenarios with a discounting rate of 10%, resutling in the B/C ratio of 1.71, 1.47, and 1.31. The study results showed that the Nongboua village would have a good opportunity to improve its low-income structure through planting and managing alternative crops such as Noni. Also the results can be used as useful decision-making information at a preliminary analysis level for planning other government and public investment projects for the Nonboua village.

• Radiation Oncology Journal
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• v.23 no.3
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• pp.143-156
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• 2005

Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.

• Journal of Yeungnam Medical Science
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• v.20 no.1
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• pp.62-70
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• 2003

Background: Most of all studies about the relation between the health risk and obesity are based on the European and American data. The purpose of this study is to examine the relation between adiposity and risk factors for cardiovacular disease (CVD) in normal weight individuals. Materials and Methods: Normal weight subjects with a body mass index (BMI) between 18.5 and $23kg/m^2$ (76 subjects) and overweight subjects with a BMI between 23 and $25kg/m^2$ (53 subjects) were retained for this study. Normal weight subjects were divided into three group of each adiposity variable, then three group and the overweight group were evaluated for the presence of CVD risk factors and analyze the correlation coefficients between adiposity variables and risk factors controlled for age in normal weight, overweight groups. Using logistic regression analysis, the odds ratio (OR) for the prevalence of risk factors for each group of adiposity variables and the overweight group was estimated relative to the first group in normal weight subjects. Results: Systolic BP, diastolic BP, LDL cholestrol, HDL cholesterol, triglycerides in normal weight subjects were significantly correlated with all adiposity variables (P<0.01). Third group (3.7 for %fat and 4.7 for fat mass)of adiposity variables in the normal weight group and the overweight group (6.6 for %fat and 11.5 for fat mass) tended to have higher ORs compared to first group for risk factor variables. Conclusion: Normal weight subjects with elevated adiposity had higher prevalence of risk factors than normal weights subjects with less adiposity. Measuring of adiposity added additional information of cardiovascular disease risk factors in normal weight subjects.

• Journal of the Korean Society of Radiology
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• v.10 no.2
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• pp.101-107
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• 2016

It was performed in this study to provide basic information on production of accurate gonadal shield by measuring pelvic indicators of TDP SD ISP IAD 1CDP and 2CDP. when pelvis ap and hip ap examination was taken, there is no exact position of the reference point of the shield and anatomically more difficult to shield gonad in the case of female infants than male. Results analyzed by height in 70~80 and 110~120 were approximately 30mm 13mm 19mm 20mm 2mm and 7mm difference in TDP SD ISP IAD 1CDP and 2CDP respectively. This value was statistically significant (P<0.05). Results analyzed by age of 2~3 and 6~7 were different on SD ISP IAD and 2CDP by 17mm 10mm 12mm 16mm respectively. it was also statistically significant. However 1CDP was not statistically significant(P>0.05). the difference was nearly about 1mm. Analysis of results by weight of less than 10 and more than 20 showed difference on TDP SD ISP IAD 1CDP and 2CDP by 28mm 14mm 11mm 20mm 3mm and 8mm. it was statistically significant (P<0.05). From the above results, female infants pelvic indicator measurement can be used as reference value for shielding production and especially IAD can present a reference point on the shielding position. Pelvis indicators of female infant has a close correlation. In addition, as it is showen in the statistical difference analysis to have an accurate ovarian shield, gonad shield would be produced and used by height, age and weight.

• Journal of Nutrition and Health
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• v.51 no.5
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• pp.465-479
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• 2018

Purpose: This study examined the frequency of sugar-sweetened beverage consumption in Korean adolescents and the major factors influencing the excessive consumption of sugar-sweetened beverages, such as sociodemographic characteristics, health-related behaviors, psychological characteristics, and dietary habits. Methods: The analysis was performed using the data from the 2017 Korean Youth Risk Behavior Web-based Survey. The subjects included in the analysis were 30,885 middle school students and 31,391 high school students, totaling 62,276. The frequency of sugar-sweetened beverage consumption was calculated by summing the consumption frequencies of soda, high caffeine or energy drinks, and sweet beverages over the last 7 days. The Rao-Scott chi-square test, reflecting information on the sampling design, was used to test the differences in the rate of sugar-sweetened beverage consumption according to each factor. Logistic regression analysis was performed to examine the factors influencing the excessive consumption of sugar-sweetened beverages. Results: The rate of sweetened beverage consumption was higher in boys than in girls, in high school students than in middle school students, in students whose father's education level was lower, in those whose subjective academic performance was lower, and in those who smoked or consumed alcohol. In addition, the rate of sugar-sweetened beverage consumption was higher in those who experienced severe stress, suicidal ideation, sadness, or a sense of despair. The rate of sugar-sweetened beverage consumption was also high in those who skipped breakfast; who frequently consumed fast foods, ramen, or snacks; and who frequently ate meals at convenience stores, supermarkets, or school stores. Conclusion: The rate of sugar-sweetened beverage consumption in Korean adolescents is related to various factors, such as sociodemographic characteristics, health-related behaviors, psychological characteristics, and dietary habits.

• Journal of Nutrition and Health
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• v.49 no.2
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• pp.111-124
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• 2016

Purpose: The current study was conducted for evaluation and comparison of dietary behavior and food intake in different regions of Lao PDR. Methods: The survey was conducted on 979 people aged 40~59 years old living in 25 urban provinces and 25 rural provinces in four districts (VTE Capital-Chanthabuly, Xaysetha, VTE Province-Phonhong, and Thoulakhom) of Laos. General demographic information, health status, and dietary behavior were surveyed using a questionnaire. Results: The literacy ratio (p = 0.000), education level (p = 0.000), asset ownership level (p = 0.000), and government and private employee ratio (p = 0.000) were higher in urban subjects compared with rural subjects. The mean value of weight (p = 0.000), waist circumference (p = 0.000), and diastolic blood pressure (p = 0.009) and alcohol consumption (p = 0.000), self-rated health status (p = 0.001), and the rate of obesity (p = 0.000) were significantly higher in urban subjects compared with rural subjects. However, the rate of current smoker was significantly higher in the rural group (p = 0.023). Meals are becoming more westernized by higher frequency of eating out, consumption of fatty meat and fried or stir-fried food in urban areas compared to rural areas. Urban subjects had relatively better balanced meals compared to rural subjects whereas they consumed insufficient meals per day and consumed meals irregularly compared to rural subjects. Intake of fruit and milk was significantly higher in urban subjects compared with rural subjects. However, the intake of vegetables was significantly higher in rural areas than urban areas. Conclusion: The result of this study showed that the traditional Lao diet is being replaced by an unhealthy western dietary pattern, which may be a risk factor for increasing development of non-communicable disease (NCD) in Lao PDR. Planning of proper personalized nutritional intervention and education in each area is needed to decrease the health risks of NCD.

• Journal of Korean Physical Therapy Science
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• v.10 no.2
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• pp.86-95
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• 2003

This study randomly chose 10 humanity high schools, which are located in Busan and KyoungNam province. We then examined the recognition rate of physical therapy among 378 teachers who were and still are working in the schools. 1. The recognition grade of physical therapeutics between men and women was significantly different with results of 80.7% of men and 69.7% of women(p<0.05). In the case of experiencing physical therapy, 83.6% of people said they knew the physical therapeutics and in the case of the opposite side, the result was also significantly different with a result of 67.8%(p<0.05). 2. We ranked the people on how much they knew about the physical therapeutics among men and women. With men, the actual experience of physical therapeutic came before what they heard from other people. In the case of women, what they heard from other people came first and the actual experience of physical therapeutic came after. According to the public information from Inje University, the recognition grade is recorded in the 3rd grade department as 21.5% while in the case of experiencing treatment from a physical therapist, the result was 39.1%. In the other department (the 1st grade department), what men and women heard from mass media was recorded at 17.5% and what they heard from other people, it was recorded at 33.8%(p<0.05). 3. The research about the recognition of academic ability of being a physical therapist was that 55.6% of teachers thought that 3-year-college was the best, which made the results different from the recognition grade of the experience of education(p<0.05). 4. In the recognition grade of physical therapeutics, there were significantly differences from 50.2% of men and 45.2% of women were expecting about 1mil ion won to 1.99million won. In case of 25.2% of people who have experience less than 15years at work, they expected about 2million to 2.99million won. The figures were higher than 10.1% of people who have experiences over 15years. About the recognition grade of physical therapists social level in the future is 48.8% of people who had experienced of physical therapy and 63.8% of people who never had experienced of it said it would be better in the future. From these results, the recognition about physical therapeutics and the view of its social status are optimistic and they know well about the level of academic ability of physical therapists. On the other hand, most teachers don't know exactly about physical therapists work. So we have to inform them aggressively for enhancing the recognition of physical therapy because high school students are well affected by their teachers when they face their future or major in university.